Provider Demographics
NPI:1316162811
Name:EARLE, MARY ELIZABETH (RN)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:EARLE
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:2987 BLUE HERON DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-2002
Mailing Address - Country:US
Mailing Address - Phone:513-896-4528
Mailing Address - Fax:
Practice Address - Street 1:112 E LIBERTY ST
Practice Address - Street 2:HEALTH RESOURCE CENTER
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-6510
Practice Address - Country:US
Practice Address - Phone:513-357-4602
Practice Address - Fax:513-357-4696
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHRN 103083 NS 05222364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health